Individual
ATHENA W TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9301 CONCORD PARK DR, MONTGOMERY, AL 36117-9235
(334) 354-1959
Mailing address
9301 CONCORD PARK DR, MONTGOMERY, AL 36117-9235
(334) 354-1959
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
04/08/2021
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